Bone Marrow vs Bloodstream: Stem Cell Source Influences Transplantation Outcomes

Blood stem cells derived from donor bone marrow resulted in better self-reported psychological well-being and fewer GVHD symptoms.
Blood stem cells derived from donor bone marrow resulted in better self-reported psychological well-being and fewer GVHD symptoms.

Blood stem cells derived from donor bone marrow resulted in better self-reported psychological well-being, fewer graft-vs-host disease (GVHD) symptoms, and earlier return to work for the recipients compared with stem cells derived from the donor's bloodstream, a study published in JAMA Oncology has shown.1

Because both the disease the recommended treatment are life-threatening for patients with leukemia or other blood malignancies, researchers sought to determine if the source of stem cells — bone marrow vs peripheral blood — would improve long-term quality of life and recovery.

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In the study, researchers randomized 551 people with leukemia or certain other blood malignancies, age 16 to 66 years, to receive transplanted cells derived from the donor's bone marrow or the donor's circulating blood. Participants were followed via periodic phone calls from 6 months to 5 years after transplantation.

Study results showed that participants who received bone marrow–derived stem cells were more likely to report better psychological well-being, and they were also more likely to have returned to work at least part-time.

Overall survival, treatment-related death, or disease relapse was similar between the two groups of participants.

“Results of this study set bone marrow as the standard source of stem cells for transplantation from unrelated donors,” said Claudio Anasetti, chair of the Department of Blood and Marrow Transplantation at Moffitt Cancer Center, and senior author of the study.

Reference

1. Lee SJ, Logan B, Westervelt P, et al. Comparison of patient-reported outcomes in 5-year survivors who received bone marrow vs peripheral blood unrelated donor transplantation: long-term follow-up of a randomized clinical trial. JAMA Oncol. 2016 Aug 11. doi: 10.1001/jamaoncol.2016.2520. [Epub ahead of print]

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